As parent/legal guardian of the child named herein, I hereby represent that the child has been examined by a pediatrician and is physically fit to participate in HappyFeet. I understand there are inherent risks in participating in this athletic program.

I hereby accept responsibility for and agree to pay any and all costs of medical treatment resulting from any injury suffered by my child as a result of his/her participation in HappyFeet. I further agree to indemnify and hold harmless HappyFeet Legends KC, its agents, servants, employees and/or representatives from any and all liability, damage, cost or expense arising out of my child's participation, of every kind and nature, in HappyFeet events.

In the event that I cannot be reached in an emergency, I hereby give permission for care to be administered by a qualified HappyFeet staff member, EMT, physician/staff of a hospital, or any other qualified individual to provide any medical treatment deemed necessary for my child.

HappyFeet may use photographs and/or videos of my child while participating in HappyFeet sponsored activities.